Category Archives: News

Newborn Azarias has skin-to-skin contact with his mother, Veronica Engel, as part of a Kangaroo Care exercise. May 15 is International Kangaroo Care Day.

This month, the Neonatal units in St. Paul and Minneapolis are celebrating the importance of Kangaroo Care, a technique where an infant is held skin to skin with mom or dad. Kangaroo Care promotes bonding, provides comfort for the baby and parent and has potential to improve a baby’s medical condition. In honor of International Kangaroo Care Awareness Day, May 15, a mother shares her experience holding her newborn son skin to skin.

Veronica Engel of Chippewa Falls, Wis., holds newborn son Azarias skin to skin as part of Kangaroo Care.

Veronica Engel

My husband and I found out at my 10-week ultrasound that we were having a baby boy, but we also found out that our son, Azarias, had a birth defect called gastroschisis.

Due to his condition, doctors informed me that I wouldn’t be able to hold Azarias until after his surgery. This had me worried because I was afraid of missing out on that special bonding time that you immediately have with your newborn. When he was born, I was able to put him on my chest momentarily but then he had to be rushed off in an isolette to be prepared for his stay at the hospital until the doctors could perform the surgery he needed. He was staying in the neonatal intensive care unit (NICU) at Children’s – St. Paul, which has private rooms. I am grateful for this because it allowed me to stay in the room with him around the clock.

I wasn’t able to hold him for the first week of his life due to his condition; however, I was able to hold his hands and feet or rub his head. After his surgery, I was able to hold him the next day. This was special because I got to hold him skin to skin; I held him for three hours straight. It was relaxing and soothing for both of us to be able to have this closeness, which we weren’t able to do at the beginning of his life. I continued to stay with Azarias in the NICU, and each day I would hold him once or twice using skin-to-skin – anywhere from an hour to three hours at a time.

The doctors told me that he was doing excellent for his condition. Not only was he gaining weight at a good pace, but he also was moving along quickly for what he was able to consume and digest.

When I’m holding Azarias skin to skin, I don’t even notice the time fly by; it’s such a relief to be able to help calm and comfort him just by this simple action. Kangaroo Care truly is a tranquil experience for parent and child and has helped us build a lasting bond with each other. I believe that being here and holding him skin to skin has made a difference in Azarias’ ability to recover and heal from this whole ordeal.

Now there’s a way for kids to fit more fun into their school days. GoNoodle is a program that offers “brain breaks” to kids as part of their class curriculum. Children’s Hospitals and Clinics of Minnesota sponsors GoNoodle in 336 Twin Cities-area elementary schools.

According to GoNoodle, 84,874 students in Minnesota participated in GoNoodle activities for more than 3.5 million minutes in April.

Roya Kebriaei, 3, is the daughter of Meysam Kebriaei, MD, and Amy Kebriaei, DDS. Roya was born with 22q, a chromosome deletion syndrome that can cause a wide range of recognizable health and developmental problems. (Photo courtesy of the Kebriaei family)

A little-known chromosome deletion syndrome called 22q will be the reason for an upcoming celebration in the Twin Cities. For the first time in Minneapolis-St. Paul, an official group will gather May 17 for “22q at the Zoo” in honor of 22q Worldwide Awareness Day.

Also known as velocardiofacial and DiGeorge syndrome, 22q is a genetic syndrome that can affect every system in the body and cause a wide range of recognizable health and developmental problems. Though little known in some circles, 22q is nearly as common as Down syndrome, affecting 1 in 2,000-4,000 children born, 1 in 68 kids born with heart disease and 5 percent to 8 percent of children with cleft palate.

The fifth annual worldwide event, which takes place each year on the third Sunday in May, will be officially recognized at the Minnesota Zoo, 13000 Zoo Boulevard in Apple Valley, one of more than 100 zoos worldwide participating. The event is scheduled for 1-2:30 p.m. and includes a kids’ party, networking for parents and a guest speaker.

Children’s Hospitals and Clinics of Minnesota pediatric neurosurgeon Meysam Kebriaei, MD, and his wife, Amy Kebriaei, DDS, established a local 22q support group made up of teams from Children’s, Gillette and University of Minnesota Masonic children’s hospitals. The couple’s 3-year-old daughter, Roya, was born with 22q.

RSVP to the event by contacting Amy Kebriaei at (218) 349-4050 or [email protected]. Go to 22q.org for more information and to order the official red 22q at the Zoo T-shirt. Proceeds benefit the International 22q Foundation.

Although allergies can develop at any age, they most commonly show up during childhood or early adulthood.

Winter exits, spring enters, and with it come irritants in the environment that can trigger allergies in children and adults. In the U.S. alone, more than 50 million people (1 in 5) are affected by allergies — which are caused by an overactive immune system — according to the American Academy of Pediatrics.

Allergies in springtime often are a trigger for asthma — May is National Asthma and Allergy Awareness Month — but asthma is a year-round concern for children, said Gigi Chawla, MD, Children’s senior medical director of primary care. Keeping refills for controller and rescue medications, especially with traveling, outings and school, up to date is important. Parents should ensure they’re making asthma checkups with their clinicians, at least yearly, in order to keep kids happy, healthy and under control.

Allergies and asthma are the most common chronic diseases among children in the U.S., according to the AAP. Many aspects of allergies, eczema and asthma are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers.

What are allergies?

Many people mistakenly use the word “allergy” to refer to a disease or almost any unpleasant or adverse reaction. In reality, allergies are reactions that usually are caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever and eczema.

Your immune system is made up of a number of different cells that come from organs throughout the body — principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).

Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy provoking substances are called “allergens.”

Allergy symptoms for ear, nose, throat and mouth

Red, teary or itchy eyes

Puffiness around the eyes

Sneezing

Runny nose

Itchy nose, nose rubbing

Postnasal drip

Nasal swelling and congestion

Itchy ear canals

Itching of the mouth and throat

Lungs

Hacking dry cough or cough that produces clear mucus

Wheezing (noisy breathing)

Feeling of tightness in the chest

Low exercise tolerance

Rapid breathing; shortness of breath

Skin

Eczema (patches of itchy, red skin rash)

Hives (welts)

Miscellaneous

Headache

Feelings of restlessness, irritability

Excessive fatigue

Where does asthma fit?

Although allergies can trigger asthma and asthma often is associated with allergies, they are two different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy.

In the summertime, exercise and humidity often are triggers. In late summer-early fall, ragweed is a trigger. Come fall, weather changes and back-to-school exposure to illness can be a trigger for asthma exacerbation, and illness is the usual culprit in the winter.

Brady German (right), of Belle Plaine, Minn., shaves his head annually at the St. Baldrick’s Foundation’s “Shave the Day” event at Children’s and raises money for cancer research in honor of his sister, Emma. Emma passed away in September, four years after being diagnosed with neuroblastoma. She was 7. (Photo courtesy of the German family)

Emma German, of Belle Plaine, Minn., passed away in September, four years after being diagnosed with neuroblastoma. Her brother, Brady, continues to raise money for cancer research and shave his head in her honor through the St. Baldrick’s Foundation’s annual “Shave the Day” event at Children’s – Minneapolis.

Brady Gervais

In the small town of Belle Plaine, Minn., everyone knows about Emma. A “girlie girl,” Emma was diagnosed with neuroblastoma in 2010 when she was 3. She loved fashion, sparkles, makeup and accessories. The more glitter, the better. She loved to dance and sing, play piano and do arts and crafts. She and her older brother, Brady, entertained their family with weekly skits and dances.

Emma was so adored that in 2013, she was invited to be a “celebrity shaver” at a St. Baldrick’s Foundation head-shaving event at Children’s that raises money for cancer research. While watching Emma shave heads, Brady was spurred to help, too. Emma’s doctor offered to donate to St. Baldrick’s if Brady became a shavee. He agreed and then challenged his mom to donate, too. Earlier that day, his mom had received an anonymous cash gift. She donated the money for the cause.

Later that night, Brady told his mom that he wouldn’t cut his hair until the following year, when people would shave the day again for St. Baldrick’s at Children’s. As his hair grew throughout 2013 and early 2014, people commented on his long locks. Whenever they did, Brady told them that he was raising money for pediatric cancer research, his sister was undergoing cancer treatment and he wanted to help kids like Emma get much-needed medicine. He raised more than $4,000.

Emma hugs big brother Brady shortly after she helped shave his head during the 2014 St. Baldrick’s Day event.

After spending four years in and out of the hospital, Emma passed away Sept. 24, 2014. She was 7. But her story doesn’t end there; it lives on in her big brother. This year, after Emma’s death, Brady has aspired to do much more.

“Brady loves and misses his little sister terribly, and it hurts him SO much to do this without her,” their mom, Keriann, said. “But raising money to help fund clinical trials that can hopefully help find treatments that can save other children battling cancer is a great way to honor someone we have lost to the disease.”

Brady recruited eight of his classmates from his fourth-grade class at Oak Crest Elementary and his favorite teacher, Mr. Don Fraser, to commit to shaving their heads and raising money, too. Brady named his team “Emma’s Acorns” — a tribute to his sister and school. He tells his friends that he wants to “help the doctors and scientists find better medicines for kids with cancer so that other kids don’t have to lose a brother or sister to cancer like he did.”

Brady (in green) recruited eight classmates and his teacher to raise money for cancer research and shave their heads this year. The group, “Emma’s Acorns,” has raised more than $10,000.

At the St. Baldrick’s event at Children’s on Thursday, Brady’s friends will wear pink, a color they unanimously picked to honor Emma. Their moms will wear purple, another favorite of Emma’s. So far, Brady and his friends have raised more than $10,000. And each one has told Keriann that they plan to shave their heads and raise money annually to honor Emma.

“I know that Emma is the reason Brady is doing this,” Keriann said, “and his friends are proud to support him in his efforts to raise money and awareness of the importance of funding clinical trials for pediatric cancer.”

Brady Gervais is an annual giving officer in the foundation at Children’s Hospitals and Clinics of Minnesota.

Brady and Emma pose next to a St. Baldrick’s Day poster featuring Emma on April 24, 2014.

Brady grows out his hair each year for the annual shaving event.

Emma assists while Brady gets his hair cut and shaved at Children’s on April 24, 2014.

Brady raises his hand during the 2014 St. Baldrick’s Day event while his mother, Keriann, stands behind him.

Emma assists while Brady gets his hair cut and shaved at Children’s on April 24, 2014.

Emma assists while Brady gets his hair cut and shaved at Children’s on April 24, 2014.

Emma hugs big brother Brady shortly after she helped shave his head during the 2014 St. Baldrick’s Day event.

Emma was dubbed queen by King Arthur during the St. Baldrick’s Day event at Children’s on April 24, 2014.

Emma wears a crown to prove she is queen during St. Baldrick’s Day at Children’s on April 24, 2014.

Brady German (right), of Belle Plaine, Minn., shaves his head annually at the St. Baldrick’s Foundation’s “Shave the Day” event at Children’s in honor of his sister, Emma. Emma passed away in September, four years after being diagnosed with neuroblastoma. She was 7. (Photo courtesy of the German family)

Brady grows out his hair each year for the annual shaving event.

Brady (in green) recruited eight classmates and his teacher to raise money for cancer research and shave their heads this year. The group has raised more than $10,000.

Those traveling to or near Children’s – St. Paul on Saturday and Tuesday are encouraged to allow extra time or find alternate routes that avoid the traffic from the LuckyPalooza (Saturday) and St. Patrick’s Day (Tuesday) events.

LuckyPalooza will be held on West Seventh Street from 2-11 p.m. During that time, West Seventh Street will be closed between Walnut Street and Kellogg Boulevard for this event, which includes music, tent parties and a stunt-bike performance.

Four days before daylight saving time starts, get your child to bed 15 minutes earlier the first night. (iStock photo)

Karen Johnson, APRN

Preparation is the key to minimize the impact of daylight saving time on your child’s sleep patterns. It’s a good idea to get your child into bed a little earlier in the week leading up to the time change.

Change the child’s body clock

Four days before daylight saving time starts — it takes place at 2 a.m. Sunday, March 8 — get your child to bed 15 minutes earlier the first night. Your child may not actually go to sleep earlier, but by getting him or her to bed sooner, you are encouraging the body to relax earlier than usual. This will lead to falling asleep earlier, too. Make the child’s bedtime progressively earlier by 15 minutes each of the four nights before daylight saving time until it adds up to an hour the night of the time change.

Daylight saving time sleep tips

Make sure that the bedroom is dark. The big challenge for parents during daylight saving time is having the child go to bed when the sun is out. Sleep is influenced by having a dark environment, as this allows for the natural secretion of melatonin that is needed to invite sleepiness.

Calm bedtime routine

Take extra care to ensure that the bedtime routine is calm and as relaxing as it can be. A calm and regular bedtime routine is best, without debates and arguing to promote sleep.

Waking too early

Ensure that your child understands that it’s not time to get up for the day. Encourage him or her to go back to sleep. Some parents put a clock beside their child’s bed and explain what time it has to be before the child can get up for the day. If you have a toddler or young child, use a sleep clock such as the Good Nite Lite. The light is a cue that informs your child to stay in bed until the sun shines on the clock in the morning. This isn’t just effective for time changes; it also can help you train an early riser not to wake Mommy and Daddy too early in the morning and may help with bedtime battles.

Get some sun

Besides making sure to get the proper amount of sleep, early morning bright light exposure also can help set a regular sleep-and-wake pattern called a “circadian rhythm.” Eating breakfast in a bright part of your house or going for an early morning walk outside in the sun will help you and your child wake easier as well.

Daily physical activity is recommended for all children, but don’t try to wear your child out in an effort to get him or her to sleep earlier. Overtired children often take longer to fall asleep and may even resist sleep completely.

Be consistent

While your child is getting used to the new sleep schedule, stick to your usual bedtime rules and routine.

Be patient during this time adjustment as you may have a tired and grumpy child on your hands in the days after the time change. It generally takes about a week after the clocks have changed to be in a new sleeping pattern. Prepare to feel unfocused in the days after you set clocks forward. You might want to keep your family’s schedule more open in the days after daylight saving time in case you aren’t well rested.

Other tips

Newborn babies usually are not affected by the start and finish of daylight saving time.

Our infection prevention and control team has received questions about the measles, mumps and rubella (MMR) vaccine from a number of concerned parents since measles and vaccinations began dominating national news coverage. Here we highlight the number of recommended doses and the times to receive the vaccine.

I want to protect my child. What is the recommendation for the MMR vaccine in Minnesota now?

Children’s Hospitals and Clinics of Minnesota, like most medical centers, follows the guidelines for vaccination as recommended by the Centers for Disease Control and Prevention (CDC) and Minnesota Department of Health (MDH).

Every child should receive two doses of MMR vaccine, with the first dose given between 12 and 15 months of age and second dose between ages 4 and 6 years old. The second dose can be given earlier as long as it comes at least 28 days after the first dose.

If a child will be traveling outside of the U.S., he or she may be given a single dose of MMR if the child is between 6 and 12 months old. However, any dose given before the first birthday will not count towards the regular schedule, and the child still will need the two doses as outlined above.

If an older child is unimmunized and wants to “catch up” on his or her immunization schedule, the child will need two doses of MMR vaccine separated by at least 28 days.

As with all medical decisions, you should discuss your concerns and plan with your clinician. Currently, the CDC is not urging earlier-than-usual vaccinations, even for young children traveling within the U.S. or attending daycare. But as the measles outbreak changes, new guidance may become available. Please continue to check Children’s and CDC websites.

The Minnesota Department of Health reported an international-travel-related measles case on the University of Minnesota campus Jan. 28. To date, there have not been any additional cases in the greater community, and children are not at increased risk.

A few additional points to remember:

Two doses is all that is required, and after that the child is considered immune.

Blood testing for immunity (or titer levels) is not recommended by the CDC.

If adults are unsure of their vaccine status, they should get at least one dose of MMR.

If you have been hesitant to vaccinate your children, take this as a wakeup call. Vaccine-preventable diseases such as measles are active outside of the U.S. and may be just a plane ride away. You can and should protect your children; immunize them.

Joe Kurland, MPH, is a vaccine specialist and infection preventionist at Children’s Hospitals and Clinics of Minnesota.

The TrialNet research study offers a blood test that can identify an increased risk for T1D up to 10 years before symptoms appear.

TrialNet offers screening to:

Anyone ages 1-45 with a parent, brother, sister or child with T1D.

Anyone age 1-20 with a niece, nephew, aunt, uncle, grandparent, half-brother/sister or cousin with T1D.

Children’s will host a free screening event from 7:30-10:30 a.m. Feb. 21 at the JDRF Walk to Cure Diabetes at the Mall of America. For more information or to refer eligible families, contact Brittany Machus, clinical research associate, at [email protected] or (651) 220-5730.

A rash forms three to five days after other measles symptoms start. (iStock Photo)

Joe Kurland, MPH

Something strange has been happening over the past few years. Infectious diseases are fighting back against the tools that have previously succeeded in protecting us all. In 2000, the U.S. announced that measles had been eliminated from the country. Our tools were so effective and some vaccine-preventable diseases were so rare, that they were all but unknown to a generation of parents and doctors. Sadly, these tools became a victim of their own success.

Measles

Measles is caused by a virus. Sometimes people say “it’s just a virus,” which ignores the fact that some of the most dangerous germs we know are viruses, measles included. It gets into your body when you inhale droplets sneezed or coughed out by someone who’s infected and is considered to be one of the most contagious diseases of which we known, with research showing that, on average, one sick person will infect as many as 18 people who are not protected. Nine out of 10 unimmunized people exposed will get measles because it is that easy to catch. This is partly because measles is an airborne virus; it can survive and infect other people who simply walk through the same room as an infected person. And the infected person doesn’t have to be in the room. The droplets are so small that the air in a room stays infectious for up to two hours after the ill person has left.

OK, measles spreads easily. But is it really that scary? What does it do?

After you’re exposed to measles, it takes between seven and 14 days to develop signs of the infection. The signs include high fever, cough, runny nose and red, watery eyes. You get a rash three to five days after those symptoms start. At first it looks like flat, red spots that show up on your head by your hairline and then spreads like a bucket of rash downwards. It covers your face, neck, chest, belly and finally your arms, legs and feet. The rash may be small, individual, raised, red bumps with flat tops, or they can join into large patches. Four days before the rash shows up, you can spread the virus to others.

For many people, the rash and fever go away after a few days, but for some there are complications. These can vary in severity from mild effects like ear infections and diarrhea to more severe symptoms such as pneumonia and swelling of the brain (encephalitis). Pneumonia is the most common (1 in 20 cases) cause of measles-related death in children, and encephalitis, while less common (1 in 1,000 cases), can cause seizures which may lead to deafness or mental disabilities. For every 1,000 children who get measles, one or two will die from it. Infections in pregnant women may result in premature delivery or a low-birth-weight baby.

You have my attention. What can I do if I’ve never had my shots and may have been exposed?

In the U.S., there are several factors working in a person’s favor:

A modern health system: Clinicians watch for measles and other diseases. If a case is found, they are required, by law, to report it to their local public health departments. The public health experts (epidemiologists) interview the sick person, notify anyone who may have been exposed and work to stop measles in its tracks by having people stay home while potentially contagious.

Effective medication: There are no antiviral medicines available to treat measles. People exposed to the sick person can protect themselves if they act quickly. If the measles vaccine (MMR shot) is given in the first few days after exposure, it can stop the virus from making you ill.

Community immunity: This is perhaps the most effective tool we have. Community immunity (also known as herd immunity) stops a disease outbreak like a firewall by stopping the virus from reaching new hosts. If you surround an infected person with people who can’t get infected with measles — because they are immune, immunized or were previously infected — the virus cannot spread and the outbreak will end. Community immunity is especially important for families where someone is immune-suppressed or who have children younger than 1 year old who are too young to be immunized.

All medical treatments have some risk. But after many studies examined MMR (measles, mumps and rubella) and other vaccines, the final word is the MMR vaccine is safe and rarely causes a severe allergic reaction.

And there is no link between the MMR vaccine and autism spectrum disorders. The association between the two repeatedly has been investigated, and no study has shown results linking the vaccine to the symptoms. In fact, newer research into autism suggests that it’s the result of unusual networking in the fetal brain in the weeks following conception.

What were you saying about our tools being a victim of their own success?

Because the vaccines and immunizations our medical system uses are so effective, the scary, deadly diseases they prevent are now rare. Paralytic polio, babies born with congenital rubella syndrome, tetanus, diphtheria are unknown and forgotten to an entire generation of parents. Because the effects of these diseases were forgotten, the tiny risks for side effects from the vaccines became the focus of concern. Combined with questionable sources in media and on the Internet, fear of vaccines grew. Pockets of underimmunized communities sprung up in cities across the U.S. and provided a foothold for vaccine-preventable diseases, imported from countries with lesser health systems, to resume their toll on a new generation of susceptible children.

But I heard the anti-vaccine community is pretty small and most people follow their pediatricians’ recommendations.

It’s true. Nationally, the number of parents electing to refuse vaccinations is low; however, in some communities, vaccine coverage is less than in war-ravaged Sudan. And this gives the diseases a chance to attack. Measles is so contagious that outbreaks may occur if any more than 5 percent of the community is unvaccinated. Some schools in Oregon and California have reported vaccine rates of 50 percent to 69 percent when anything less than 95 percent vaccinated has great potential for an outbreak.

Vaccines have been so effective that we lost our fear of the diseases they prevented. Amnesia created doubt and hostility towards the utility and need for protection. It is up to parents to protect not only our own children against measles, but in doing so, know that we protect others, too.

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